With the increase in coronavirus vaccinations, the easing of strict guidelines, and the return to school in some communities, it’s easy to think that the worst of this pandemic is behind us. But the pandemic has given rise to a mental health crisis of monumental proportions among our young people.
“The number of new referrals, as well as the number of eating disorder hospitalizations, has doubled at the hospital over the past year,” says Lisa Tuchman, chief adolescent medicine at Children’s DC National Hospital.
As a pediatrician, I have seen the skyrocketing myself and have spoken to many parents about the issue.
So, as we dream of a return to our routines and normal lives, what do teens, parents, caregivers and educators need to know about detecting and combating eating disorders? Here are the questions I have heard from parents and my answers, so that we can respond to this growing youth health crisis.
Q: My 16 year old son has been attending online school for over a year. Over the past few months, he has started to exercise compulsively, becoming more and more picky about the foods he eats and appearing thinner than before. He says he’s not worried about his appearance, but we’re concerned about these recent changes. Is it possible that he has a feeding problem related to the pandemic, and what should we do?
A: Many children suffered from anxiety and depression during the pandemic. In some cases, teens may also use over-exercise and food restriction to deal with the loss of control over their daily lives. Although eating disorders are more common in teenage girls, they can certainly occur in boys (sometimes as young as 10 years old). Start by having a conversation with your son about losing his normal routines, feelings of isolation, changes in his habits, and how he is coping. Ask them specifically if they are feeling depressed, if they have tried to cut, or if they are feeling suicidal. Based on your description, you should consider having your son speak to his pediatrician to make sure he does not have early signs of compulsive exercise or avoidant / restrictive food intake disorder (ARFID), which involves a high level of spiciness in the diet and a general lack of interest in food, which can lead to weight loss and malnutrition. To help him cope with the pandemic, discuss ways for him to stay in touch with friends and family. Also, consider focusing on ways he can give back to the community and develop an “attitude of gratitude,” both of which have reduced stress and improved overall well-being.
Q: Our daughter is frequently on Instagram and Snapchat, following sites related to pop singers and models. Her friends are also on the same sites and frequently comment on the looks. She recently said she was stressed and munched on large amounts of food late at night. She uses social media to stay in touch with her friends, especially now. So despite this, should we limit its use?
A: Researchers found that teens who spent more time on social media apps were 2.2 times more likely to have poor body image than their peers. In a recent study by Jason Nagata and colleagues at the University of California at San Francisco, the more time 9 and 10-year-olds spend on screens, the more likely they are to engage in uncontrolled or binge eating. For some teens, social media content and a focus on certain body types can reinforce messy thoughts. Help your daughter train her lens on her abilities as opposed to her outward appearance. Encourage her to spend time with friends who feel good about their bodies and who don’t always criticize themselves or others. Ask her to take a break from Instagram for a short while. Also chat with her about healthier ways to deal with stress and emotions, such as yoga, mindfulness, journaling, and exercise. She could take an online eating disorder screening quiz. Finally, encourage your daughter to challenge media standards which are often unrealistic. The Dove Self-Esteem Project, for example, has created a wonderful set of resources for parents to promote body positivity in teens.
Q: Our 11 year old daughter commented on her weight and appearance and compared them to her friends. She just had a growth spurt and has acne. What signs indicate that she may be having difficulty with her body image compared to what is developmentally normal?
A: I often ask teens, “When you look at yourself in the mirror, what do you see and are you happy with it?” If your daughter spends occasional days feeling unhappy with her body or uncomfortable with puberty changes, that’s okay. However, if she is consistently dissatisfied with how she looks or compares herself to others, it is important that she refocus on what is inside, such as her unique abilities. You should also consider additional support from a mentor, counselor, or pediatrician before their behaviors lead to eating disorders or other unhealthy practices. Parents should be careful not to make weight-related comments about themselves or others in front of their children. A study by Common Sense Media showed that more than half of girls and a third of boys aged 6 to 8 thought their ideal weight was thinner than their current height. The good news is that as a parent, you have more influence than you think in helping your child build a healthy self-image. Regular body image checks, minimizing ‘profanity,’ celebrating talents and abilities, and, if needed, getting support early on are all helpful in ensuring that your daughter will feel positive during her teenage years and throughout her life. -of the.
Q: The pandemic has been difficult for our family and we have all struggled to stay as active as before. Our preteen was recently told by her doctor during a routine visit that she was overweight. She is now constantly worried about her weight, has tried a variety of diets, and recently went vegan. How do we make sure she stays healthy?
A: The pandemic has been difficult for many families and it has been difficult to get the children outside or to exercise. Looks like your daughter got too preoccupied with dieting after learning that she was overweight. Focus on health, not weight, and encourage her to avoid fad diets, purges, laxatives, or other quick fixes. In some cases, suddenly becoming a vegetarian or vegan can be a clue to having an eating disorder. I encourage your daughter to eat regular meals and make sure she is getting enough vitamin B12 and iron. She could benefit from a meeting with a nutritionist. One positive aspect of the pandemic is that most providers meet virtually. Brainstorm with her about the exercise she enjoys and how she can incorporate it into her life on a regular basis. Consider modeling behaviors and exercising together, including regular family hikes, bike rides, or online fitness workouts from places like PopSugar or Nike. Finally, make sure she turns off devices and gets enough sleep at night, as this can help regulate appetite and metabolism.
Q: Our 15 year old daughter is an elite ballet dancer. Although ballet lessons are online, she trains several hours a day for an upcoming virtual performance, for which her coaches have instructed her to maintain a certain weight. Lately, she has complained of being cold all the time, having frequent dizziness, losing hair and not being able to concentrate. Her doctor has mentioned in the past that she has a low heart rate. She recently lost a few pounds. Our daughter thinks that all of this is related to the increase in practices and the lack of drink. Is there anything we should consider to prepare for its performance?
A: If your daughter is an elite athlete and exercises several hours a day, it is important that she gets the calories she needs. During adolescence, adolescents grow older, their brains develop, and their bodies build bones and muscles. Your daughter’s symptoms could mean that she should be screened for the first signs of anorexia (restrictive eating, a strong desire to be thin, fear of gaining weight) or other medical problems. Anorexia can cause serious medical complications affecting the heart, brain, and other organs. You should have a conversation with your daughter’s ballet company about weight expectations. Your daughter should also see her pediatrician for a full checkup. . Treatment for anorexia varies, but it may involve asking a therapist to address weight and eating behaviors, often with an emphasis on family-centered care; a primary care provider to monitor lab tests and weight; and a nutritionist to review a diet plan. In severe cases, some adolescents require hospitalization for intensive nutritional treatment or partial / full management of institutional eating disorders. Your daughter has a wonderful gift with ballet. She needs to be supported early on to make sure she stays healthy and injury-free.